Burns

Question 1

List four signs of an inhalation burn.

Answer 1

Single nasal hairs, circumoral burns; sooty or bloody sputum, hoarseness, and pulmonary signs, including asymmetry of respirations, rales, or wheezing.

Question 2

List four categories of burns.

Answer 2

Thermal, radiation, chemical, electrical

Question 3

Burn depth is a measure of severity. Describe the characteristics of superficial partial-thickness, deep partial-thickness, and full-thickness burns.

Answer 3

• Superficial partial-thickness (first degree): pink to red skin (e.g. sunburn), slight edema, and pain relieved by cooling
• Deep partial-thickness (second degree): destruction of epidermis and upper layers of dermis; white or red, very edematous, sensitive to touch and cold air, hair does not pull out easily
• Full-thickness (third degree): total destruction of dermis and epidermis; reddened areas do not blanch with pressure; not painful; inelastic; waxy white skin to brown, leathery eschar

Question 4

Describe fluid management in the emergent phase, acute phase, and rehabilitation phase of the burned client.

Answer 4

• Stage I (emergent phase): Replacement of fluids is titrated to urine output.
• Stage II (acute phase): Patent infusion site is maintained in case supplemental IV fluids are needed; saline lock is helpful; colloids may be used
• Stage III (rehabilitation phase): No extra fluids are needed, but high-protein drinks are recommended

Question 5

Describe pain management of the burned client.

Answer 5

Administer pain medication, especially prior to dressing wound. Teach distraction and relaxation techniques. Teach use of guided imagery.

Question 6

Outline admission care of the burned client.

Answer 6

Provide a patent airway because intubation may be necessary. Determine baseline data. Initiate fluid and electrolyte therapy. Administer pain medication. Determine depth and extent of burn. Administer tetanus toxoid. Insert NG tube.

Question 7

Nutritional status is a major concern when caring for a burned client. List three specific dietary interventions used with burned clients.

Answer 7

High-calorie, high-protein, high-carbohydrate diet; medications with juice or milk; no “free” water; tube feedings at night. Maintain accurate, daily calorie counts. Weight client daily.

Question 8

Describe the method of extinguishing each of the following burns: thermal, chemical, and electrical.

Answer 8

• Thermal: remove clothing, immerse in tepid water
• Chemical: flush with water or saline
• Electrical: separate client from electrical source

Question 9

Why is the burned client allowed no “free” water?

Answer 9

Water may interfere with electrolyte balance. Client needs to ingest food products with highest biologic value.

Question 10

Describe an autograft.

Answer 10

Use of client’s own skin for grafting.